Abstract: Objective To evaluate the predictive value of metalloproteinase-inhibiting factors (TIMPs) for in-hospital death in the elderly patients with chronic heart failure. Methods A total of 394 patients with CHF in our hospital during January 2018 to January 2020 were divided into in-hospital death group(n=40) and non-in-hospital death group(n=354). The levels of TIMPs were compared between the two groups. The risk factors of in-hospital death were analyzed by Logistics regression model. ROC curve was used to analyze the predict value for in-hospital death. Results Early serum levels of TIMP-1, TIMP-2 and TIMP-4 in in-hospital death group were lower than those in non-in-hospital death group(P<0.05). ROC curve showed that optimal cut-off value of serum TIMP-1 at the early stage after admission was 149.40 pg/mL, with an AUC of 0.751(95%CI: 0.657-0.846), with a sensitivity and specificity of 74.07% and 62.50% respectively. Optimal cut off value of serum TIMP-2 was 180.30 pg/mL, with an AUC of 0.819(95%CI: 0.734-0.905), with a sensitivity and specificity of 78.75% and 75.00% respectively. Optimal cut off value of TIMP-4 was 193.30 pg/mL, with an AUC of 0.746(95%CI: 0.649-0.843), with a sensitivity and specificity of 63.75% and 70.00% respectively. According to Logistics regression analysis, age over 70 years old, low hemoglobin level, TIMP-1<149.40 pg/mL, TIMP-2<180.30 pg/mL, TIMP-4<193.30 pg/mL, high NT-proBNP level were independent risk factors for in-hospital death in the elderly CHF patients(P<0.05). Conclusions Low serum levels of TIMP-1, TIMP-2 and TIMP-4 are independent risk factors for in-hospital death in the elderly patients with CHF after admission, which has early predictive value for in-hospital death.

Key words: aged, chronic heart failure, metalloproteinase tissue inhibitor, in-hospital death, predict value